rules and regulationsreportable disease exists or is suspected of existing in a specified person...
TRANSCRIPT
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RULES ANDREGULATIONS
of the
State DepartmentOf Health
for the
CONTROL OFCOMMUNICABLE DISEASES
ADOPTED APRIL 11, 1943
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RULES AND REGULATIONS OF THE STATE DEPARTMENT OFHEALTH FOR THE CONTROL OF COMMUNICABLE DISEASES
Words and Terms Defined
Regulation I.—Certain words and terms used in these rules andregulations are defined as follows;
(a) Communicable Disease.—A communicable disease is a dis-ease incited by the entrance into a body and the multiplication there-in of disease-producing organisms capable of being transmitted,directly or indirectly, to other persons or animals. The term com-municable disease embraces the common term contagious and in-fectious disease.
(b) Report of a Disease.—By report of a disease is meant thenotification to the State and local health department that a case ofreportable disease exists or is suspected of existing in a specifiedperson or persons at a given address.
(c) Infectious Agent.—An infectious agent is a living micro-organism, capable, under favorable conditions, of inciting a com-municable disease.
The words, germ, organism, microorganism and infectious agentare used interchangeably.
(d) Incubation Period.—The incubation period of a communi-cable disease is the interval which usually elapses between the en-trance into the body of the disease-producing organism and themanifestation of the first symptoms of the disease.
(e) Period of Communicability.—The period of communicabilityis the time during which a person affected with a communicabledisease is capable of transmitting the infectious agent to others.
(f) Susceptibles.—A susceptible is a person or animal who isnot known to be immune to a communicable disease.
(g) Immunes.—An immune is a person who is not susceptibleto the influence of a particular infectious agent. Immunity usuallyfollows recovery from an attack of a disease or successful vaccineor serum treatment.
(h) Contacts.—A contact is a person or animal that has beensufficiently near to an infected person, animal or thing to makeprobable the transmission of the infectious agent to him.
(i) Carriers.—A carrier is one who harbors in his body, themicroorganisms of a communicable disease, but who at the time isapparently in good health. A carrier may convey the infectiousagent to another person and, under favorable conditions, the germsmay incite the disease in his own body.
(j) Cultures.—Cultures are growths of microorganisms propa-
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gated in or upon artificial media for the purpose of determining thepresence of disease-producing organisms.
(k) Isolation.—lsolation consists of the limitation of the freedomof persons or animals who are presumably affected with, or car-riers of, or who have been exposed to, communicable disease, andthe taking of measures to secure the prompt and regular disinfec-tion of all infected body secretions and excretions and of all in-fected or presumably infected materials.
(1) Placards.—A placard is an official notice, written or printed,posted as a warning of the presence of a communicable disease onthe premises or in the apartment or room so placarded.
(m) Disinfection.—Disinfection is the process of destroying thevitality of disease-producing organisms by physical or chemicalmeans.
(n) Concurrent Disinfection.—Concurrent disinfection signifiesthe immediate disinfection and disposal of body discharges, and theimmediate disinfection or destruction of all infected or presumablyinfected materials.
(o) Terminal Disinfection.—Terminal disinfection signifies theprecautions taken to destroy or remove infectious material after theremoval of the patient or the termination of isolation.
Diseases Declared ReportableRegulation 2.—The following list of diseases are declared to be
reportable to the State and the local health departments:ActinomycosisAnthraxChancroidChickenpox (varicella)CholeraCoccidioidomycosis (coccidioidal
granuloma, "Valley fever")Conjunctivitis, acute infectious
(of the newborn, not includingtrachoma). ..
DengueDiphtheriaDysentery, amebic (amebiasis)Dysentery, bacillaryEncephalitis, infectious (lethargic
and nonlethargic)German measles (rubella)GlandersGonorrheaGranuloma InguinaleHemorrhagic jaundice (spiro-
chetosis icterohemorrhagic,
Weil's disease)Hookworm disease (ancylosto-
miasis)InfluenzaLeprosyLymphogranuloma venereum
(inguinale) (climatic bubo)MalariaMeasles (rubeola)Meningococcus meningitis(cerebrospinal fever)
Mumps (infectious parotitis)Paratyphoid feverPlague, bubonic, septicemic,
pneumonicPneumonia, acute lobarPoliomyelitisPsittacosisPuerperal infection
(puerperal septicemia)RabiesRelapsing fever
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Rheumatic feverRocky Mountain spotted (or tick)
feverScarlet fever (scarlatina)Septic sore throatSmallpox (variola)SyphilisTetanusTrachomaTrichinosis
Tuberculosis, pulmonaryTuberculosis, other than pul-
monaryTularemiaTyphoid feverTyphus feverUndulant fever (brucellosis)Whooping cough (pertussis)Yellow fever
The following diseases are reportable but not communicable:Botulism PellagraFood infections and poisonings
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DISEASESDECLARED
COMMUNICABLE
Regulation3.—Thefollowinglistofdiseasesaredeclaredtobecommunicableandsubjecttothecontrol measuresgiven.Theincubationperiodandtheminimumperiodofcommunicabilitygivenarethose
generally
acceptedandofficially
adopted.
DISEASEINCUBATION PERIOD
MINIMUMPERIODOF COMMUNICABILITY
CONTROLMEASURES
PATIENT
CONTACTS
ActinomycosisUndetermined
Aslongasopen
lesions
remain
Noisolationifunder
medicalcare
None
‘AnthraxWithin7
daysUntil
openlesionsheal
Noisolationifunder
medicalcare
None
Chancroid3to14days
Untilalllesionsare
healed
SeeRegulation
11
SeeRegulation
11
Chickenpox2to3weeks
10days
afterfirst appearanceof
eruptionIsolation
Exclusionfrom
school
‘Cholera1
to5
days
Untilinfectiousorganism
isabsentfrom
boweldis-
charges
Isolationin
screenedroomduringcommuni-
cableperiod
Isolationfor5
days
fromlast
exposureplusstoolculture
negativeforcholera
vibrio
Conjunctivitis, acuteinfectious36to48hoursUntil
dischargescease
Isolationduringperiod
of
communicabilityNone
Dengue
3to15days
5
daysfromonsetof
disease
Patientisolatedin
screenedroomfor5
daysfromdateofonset
None
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*
Diphtheria2to5
daysMSj
;
-(■
..'Ai-
Untilvirulentdiphtheria
bacillihave
disappearedfromall
secretionsand
lesions
Isolationuntil2
nose
andthroator
othercul-
turestakennotlessthan
24hoursapartfailto
showvirulent
diphtheriabacilli
to..
Isolated(same
as
forpatient)
Dysentery, amebic2
daysto4
weeks
Duringcourseof
infec-
tionasdetermined
by
microscopicexamination
ofstools
Restrictedfromfood
handlingduring
period
of
communicabilityNone
‘Dysentery, bacillary1
to7
days
Untilmicroorganismis
absentfrom
boweldis-
charges
Isolationduringstageof
disease
None
Encephalitis, infectious4to21days
Unknown
Isolationinscreened
roomfor1
weekafter
onset
None
Gonorrhea1
to8
days
Aslongas
thegonococ-
cuspersistsinanyofthe
discharges
SeeRegulation11
SeeRegulation
11
Granuloma inguinale2
weeksto
1
month
UndeterminedSee
Regulation11
SeeRegulation
11
Leprosy
1
toseveral years mrisUntil
diseaseis
arrestedfor6
months
Isolationuntil
releasedbyState
Departmentof
Health
None
‘Concurrentand
termindhdigirifectionrequired.■
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DISEASEINCUBATION PERIODMINIMUM
PERIODOF COMMUNICABILITY
CONTROLMEASURES
PATIENT
CONTACTS
Lymphogran- ulomavenereum1
to4weeks
Aslongasthereareopen
lesionsupon
skinor
mucousmembranesSee
Regulation11
SeeRegulation11
MalariaVariesaccord-
ingtotype
Periodofinfection
Patientprotectedfrom
mosquitoes
None
Measles10to15days
From4to5
daysafter
appearanceofrash
Isolationfromonsetof
catarrhalsymptomuntil
5
daysafter
appearanceof
rash
None
Measles, German14to21days
4to7
days
None
None
Meningococcus meningitis(cere- brospinalfever)2to10days
Duringclinical
courseof
disease
Isolationfor14daysfrom
onset
Isolationfor10
days
fromdateoflast
knowncontact.
Mumps
12to26days
Aslongas
swellingof
salivaryglands
persistsIsolationuntilswelling
subsides
None
*Plague,bubonic septicemic pneumonic3
to7
days sometimes14
days
Pneumonic—during
acutestagesof
disease
Strictisolationof
pneu-
monictypeduring
acute
symptomof
diseasePneumonic—strict
isolationfor7
days
afterlastcontact
‘Pneumonia, acutelobar1
to3
days,not
welldetermined
Unknown
Isolationduring
febrile
periodof
disease
None
‘Poliomyelitis7to14days
UndeterminedIsolationfor2weeksfrom
onsetpreferablyin
screenedroom
Exclusionfromall
publicgatherings
for14days
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‘Psittacosis6to15
days
Duringacuteillness
especiallywhencough-
ing
Strictisolationduring
febrilestage
None
Rabies
Usually2to6
weeks,maybe6
monthsor
longerUndetermined
Isolation
None
RockyMountain
spottedfever
3to
about10
days
Notcommunicablefrom
man
None
None Exclusionof
ex-
‘Scarletfever2to7
days
Usually3
weeksfrom
onsetof
diseaseand
un-
til
allabnormaldis-
chargescease
andle-
sionsheal
Isolationduring
periodof
communicabilityposedchildrenand
teachersfrom
school,foodhand-
lersfromworkfor
7
daysfromlast
ex-
posure
‘Septicsorethroat1
to3
days
Duringcontinuanceof
clinicalsymptoms
Isolationduring
periodof
communicabilityExclusionof
ex-
posedchildrenand
teachersfrom
school,foodhand-
lersfromworkfor
3
daysfrom
ex-
posure
‘Smallpox8to16days
Fromfirst
symptomsto
disappearanceof
all
scabsand
crusts
Isolationuntilallscabs
disappear
Isolationfor16days
fromlast
exposureor
untilevidenceof
successfulvaccina-
tionfollowing
ex-
posure
‘Concurrentand
terminaldisinfection
required.
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10
DISEASEINCUBATION PERIODMINIMUM
PERIODOF COMMUNICABILITY
CONTROLMEASURES
PATIENT
CONTACTS
Syphilis
About3
weeks, occasionally longerAslongas
lesionsare
openuponmucousmem-
branesor
skin,practical-
lylimitedtothefirst2
yearsofdisease
SeeRegulation
11
SeeRegulation
11
TrachomaUndetermined
Duringpersistenceof
lesions
Exclusionfromschool
duringperiodof
com-
municability
None
‘Typhoidand Paratyphoid3to38days
Aslong
qsstoolor
urine
is
positive
Isolationin
fly
proof
roomuntil2
successivenegative
culturesofstool
andurinespecimens
col-
lectednotlessthan24
hoursapart
Recommendimmun-
izationofall
non-
immunecontacts
Typhusfever6to14days
In
presenceofliceuntil
36hoursafternormal
temperature
Isolationinvermin
free
roomduring
courseof
disease
None
Whoopingcough7to16days
3
weeksafteronsetof
typicalparoxysms
Isolationfor3weeksafter
typicalwhoopdevelops
None
Yellowfever3to6
days
2
dayspriortoonsetof
feverandfirst4
daysof
fever
Isolationfrom
mosquitoesduringacutestageofdis-
ease
None
‘Concurrentand
terminaldisinfection
required.
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General Measures for Control of Communicable DiseasesRegulation 4.—The local health officer, in instituting measures
for the control of communicable diseases,(a) shall make, or cause to be made, such investigation as may
be necessary for the purpose of securing data regarding contactsand, if possible, the time, place, and source of infection;
(b) shall establish and maintain isolation or such other meas-ures for control as required by rules and regulations of the StateBoard of Health;
(c) shall provide, directly or indirectly, for the instruction ofpersons affected, and their attendants, in the proper methods ofconcurrent disinfection;
(d) shall introduce such other measures, consistent with therules and regulations of the State Board of Health, as may bedeemed advisable because of widespread infection or threatenedepidemic;
(e) suspected cases of communicable diseases shall be subjectto the administrative procedures specified for cases of the diseaseuntil the diagnosis is determined or laboratory tests required for therelease of cases have been found to be negative.
(f) When a health officer has reasonable grounds to believethat a person or persons may have been exposed to a communicabledisease, he may control them as known contacts, making such ex-aminations and adopting such measures amhe. deems necessaryand proper for the'protection of public health arid the prevention ofthe spreading of disease.
(g) A placard may be used in the control of any communicabledisease at the discretion of the health officer.
RabiesRegulation s.—Whenever rabies is prevalent in any area or
locality in the state, the local City, or County health officer shallmake such examinations and adopt such measures as he deemsnecessary or proper for the protection of the public and the preven-tion of the spreading of the disease; and shall require the detention,isolation and examination of animals suspected of having rabies,and the isolation by the owner of all dogs in areas where rabidanimals have run at large. All unlicensed stray dogs should beimpounded and destroyed.
Restrictions on Food Handlers
Regulation 6.—No person can be employed to handle or pre-pare food until he has had a comprehensive examination by alicensed physician and surgeon and has been found free from anycommunicable disease in an infectious stage.
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Removal to Hospital of Certain CasesRegulation 7.—When, in the opinion of the health officer or the
State superintendent of health, proper isolation of an affected per-son or persons, carrier, or contact is not or can not be effectivelymaintained on the premises occupied by such person or persons, hemay remove or require the removal of such person or persons to ahospital or other proper place designated by him.
Invasion of Isolation AreasRegulation 8.—No person other than the attending physicians
and authorized attendants shall enter or leave, and no one exceptthe health officer or his representative shall permit any other per-son to enter or leave any room, apartment, or premises where acommunicable disease is isolated.
No person shall remove any article from an isolated area with-out permission of the health officer.
Duty of Health Officer When Infected Person Leaves HisJurisdiction Without Permission
Regulation 9.—lt shall be the duty of the local health officerto report immediately to the State superintendent of health by tele-phone or telegraph the name, address, probable destination androute of departure of any person who is affected with a communica-ble disease, who has left his jurisdiction without his consent.
Method of Control of TuberculosisRegulation 10.—All cases of tuberculosis, regardless of type,
shall be reported to the local health officer and the State Departmentof Health.
When, in the opinion of the health officer or the State superin-tendent of health, proper isolation of a person affected with pulmon-ary tuberculosis in a communicable stage is not or can not be ef-fectively maintained on the premises occupied by such person orpersons, he may remove or require the removal of such person orpersons to a hospital or other place designated by him, there toremain in isolation for such a time as the health officer deems suchperson or persons to be a menace to the public health.
Method of Control of Venereal DiseasesRegulation 11.—Venereal diseases as referred to in this regu-
lation include syphilis, gonorrhea, chancroid, lymphogranulomavenereum and granuloma inguinale.
Where, in the opinion of the health officer or the State superin-tendent of health, proper isolation of a person affected or suspectedof being affected with a venereal disease is not or can not be ef-fectively maintained on the premises occupied by such person or
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persons, he may remove or require the removal of such person orpersons to a hospital or other place designated by him, there to re-main in isolation for such a time as the health officer deems suchperson or persons to be a menace to the public health.
When a health officer has reasonable grounds to believe thata person or persons may have been exposed to a venereal diseasehe may control them as known contacts, making such examinationsand adopting such measures as he deems necessary and properfor the protection of public health and the prevention of the spread-ing of disease.
All information received by health officers in reports of venerealdisease cases and contacts shall be considered as confidential andshall not be revealed to any other person except when in the opinionof the health officer such revelation is necessary to protect the publichealth.
For the prevention of gonorrheal ophthalmia, the physician orperson attending the birth of a child shall drop two drops of onepercent aqueous solution of silver nitrate into the eyes of the babyimmediately after birth.
RepealAll rules and regulations of the State Board of Health for
the control of communicable diseases adopted and in force prior toApril 11, 1943, are repealed.
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